Active NPI
Stacey Cotsenmoyer Lee Cotsenmoyer, PTA
- Physical Therapy Assistant
- Leesburg, FL
National Provider Identifier
1700920733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA12538
- Practice address
- 600 North Blvd. West Lake Centre for Rehabilitation
Leesburg, FL 34748 - Phone
- (352) 728-6636
- Fax
- (352) 787-4522
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA12538 | FL | Primary |
Addresses
Primary practice location
600 North Blvd. West Lake Centre for Rehabilitation
Leesburg, FL 34748
Mailing address
11 Live Oak Ave
Yalaha, FL 34797-3031
Other names 1
- Stacey Lee Allison
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA12538 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700920733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 LIVE OAK AVE",
"city": "YALAHA",
"state": "FL",
"postal_code": "347973031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 NORTH BLVD. WEST LAKE CENTRE FOR REHABILITATION",
"city": "LEESBURG",
"state": "FL",
"postal_code": "34748",
"telephone_number": "352-728-6636",
"fax_number": "352-787-4522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTSENMOYER",
"first_name": "STACEY COTSENMOYER",
"middle_name": "LEE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA12538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STACEY",
"last_name": "ALLISON",
"middle_name": "LEE",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Leesburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.